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THE COMPARISON
A Pink scaling plaques and erythematous erosions in the antecubital fossae of a 6-year-old White boy.
B Violaceous, hyperpigmented, nummular plaques on the back and extensor surface of the right arm of a 16-month-old Black girl.
C Atopic dermatitis and follicular prominence/accentuation on the neck of a young Black girl.
Epidemiology
People of African descent have the highest atopic dermatitis prevalence and severity.
Key clinical features in people with darker skin tones include:
- follicular prominence
- papular morphology
- prurigo nodules
- hyperpigmented, violaceous-brown or gray plaques instead of erythematous plaques
- lichenification
- treatment resistant.1,2
Worth noting
Postinflammatory hyperpigmentation and postinflammatory hypopigmentation may be more distressing to the patient/family than the atopic dermatitis itself.
Health disparity highlight
In the United States, patients with skin of color are more likely to be hospitalized with severe atopic dermatitis, have more substantial out-of-pocket costs, be underinsured, and have an increased number of missed days of work. Limited access to outpatient health care plays a role in exacerbating this health disparity.3,4
1. McKenzie C, Silverberg JI. The prevalence and persistence of atopic dermatitis in urban United States children. Ann Allergy Asthma Immunol. 2019;123:173-178.e1. doi:10.1016/j.anai.2019.05.014
2. Kim Y, Bloomberg M, Rifas-Shiman SL, et al. Racial/ethnic differences in incidence and persistence of childhood atopic dermatitis. J Invest Dermatol. 2019;139:827-834. doi:10.1016/j.jid.2018.10.029
3. Narla S, Hsu DY, Thyssen JP, et al. Predictors of hospitalization, length of stay, and costs of care among adult and pediatric inpatients with atopic dermatitis in the United States. Dermatitis. 2018;29:22-31. doi:10.1097/DER.0000000000000323
4. Silverberg JI. Health care utilization, patient costs, and access to care in US adults with eczema. JAMA Dermatol. 2015;151:743-752. doi:10.1001/jamadermatol.2014.5432
Candrice R. Heath, MD
Temple University Hospital
Philadelphia, PA
Richard P. Usatine, MD
University of Texas Health at San Antonio
The authors reported no potential conflict of interest relevant to this article.
Simultaneously published in Cutis and The Journal of Family Practice.
Candrice R. Heath, MD
Temple University Hospital
Philadelphia, PA
Richard P. Usatine, MD
University of Texas Health at San Antonio
The authors reported no potential conflict of interest relevant to this article.
Simultaneously published in Cutis and The Journal of Family Practice.
Candrice R. Heath, MD
Temple University Hospital
Philadelphia, PA
Richard P. Usatine, MD
University of Texas Health at San Antonio
The authors reported no potential conflict of interest relevant to this article.
Simultaneously published in Cutis and The Journal of Family Practice.
THE COMPARISON
A Pink scaling plaques and erythematous erosions in the antecubital fossae of a 6-year-old White boy.
B Violaceous, hyperpigmented, nummular plaques on the back and extensor surface of the right arm of a 16-month-old Black girl.
C Atopic dermatitis and follicular prominence/accentuation on the neck of a young Black girl.
Epidemiology
People of African descent have the highest atopic dermatitis prevalence and severity.
Key clinical features in people with darker skin tones include:
- follicular prominence
- papular morphology
- prurigo nodules
- hyperpigmented, violaceous-brown or gray plaques instead of erythematous plaques
- lichenification
- treatment resistant.1,2
Worth noting
Postinflammatory hyperpigmentation and postinflammatory hypopigmentation may be more distressing to the patient/family than the atopic dermatitis itself.
Health disparity highlight
In the United States, patients with skin of color are more likely to be hospitalized with severe atopic dermatitis, have more substantial out-of-pocket costs, be underinsured, and have an increased number of missed days of work. Limited access to outpatient health care plays a role in exacerbating this health disparity.3,4
THE COMPARISON
A Pink scaling plaques and erythematous erosions in the antecubital fossae of a 6-year-old White boy.
B Violaceous, hyperpigmented, nummular plaques on the back and extensor surface of the right arm of a 16-month-old Black girl.
C Atopic dermatitis and follicular prominence/accentuation on the neck of a young Black girl.
Epidemiology
People of African descent have the highest atopic dermatitis prevalence and severity.
Key clinical features in people with darker skin tones include:
- follicular prominence
- papular morphology
- prurigo nodules
- hyperpigmented, violaceous-brown or gray plaques instead of erythematous plaques
- lichenification
- treatment resistant.1,2
Worth noting
Postinflammatory hyperpigmentation and postinflammatory hypopigmentation may be more distressing to the patient/family than the atopic dermatitis itself.
Health disparity highlight
In the United States, patients with skin of color are more likely to be hospitalized with severe atopic dermatitis, have more substantial out-of-pocket costs, be underinsured, and have an increased number of missed days of work. Limited access to outpatient health care plays a role in exacerbating this health disparity.3,4
1. McKenzie C, Silverberg JI. The prevalence and persistence of atopic dermatitis in urban United States children. Ann Allergy Asthma Immunol. 2019;123:173-178.e1. doi:10.1016/j.anai.2019.05.014
2. Kim Y, Bloomberg M, Rifas-Shiman SL, et al. Racial/ethnic differences in incidence and persistence of childhood atopic dermatitis. J Invest Dermatol. 2019;139:827-834. doi:10.1016/j.jid.2018.10.029
3. Narla S, Hsu DY, Thyssen JP, et al. Predictors of hospitalization, length of stay, and costs of care among adult and pediatric inpatients with atopic dermatitis in the United States. Dermatitis. 2018;29:22-31. doi:10.1097/DER.0000000000000323
4. Silverberg JI. Health care utilization, patient costs, and access to care in US adults with eczema. JAMA Dermatol. 2015;151:743-752. doi:10.1001/jamadermatol.2014.5432
1. McKenzie C, Silverberg JI. The prevalence and persistence of atopic dermatitis in urban United States children. Ann Allergy Asthma Immunol. 2019;123:173-178.e1. doi:10.1016/j.anai.2019.05.014
2. Kim Y, Bloomberg M, Rifas-Shiman SL, et al. Racial/ethnic differences in incidence and persistence of childhood atopic dermatitis. J Invest Dermatol. 2019;139:827-834. doi:10.1016/j.jid.2018.10.029
3. Narla S, Hsu DY, Thyssen JP, et al. Predictors of hospitalization, length of stay, and costs of care among adult and pediatric inpatients with atopic dermatitis in the United States. Dermatitis. 2018;29:22-31. doi:10.1097/DER.0000000000000323
4. Silverberg JI. Health care utilization, patient costs, and access to care in US adults with eczema. JAMA Dermatol. 2015;151:743-752. doi:10.1001/jamadermatol.2014.5432
